Friday, 20 Oct 2017

News

Pegloticase Infusion Reactions Largely Seen in Non-Responders

The introduction of intravenous pegloticase (PEG) in 2010 was felt by many to be a major advance in the treatment of patients with severe, refractory tophaceous gout.  But for some, concerns over infusion reactions and safety have limited its use.

The RheumNow Week in Review – 18 August 2017

The RheumNow Week in Review discusses the past week's news, journal articles and highlights from RheumNow.com. This week's report includes new data on lupus survival, pediatric lupus guidelines from SHARE, room temperature storage of etanercept, over or under-testing by rheumatologists and failure of pain meds to treat pain.

Bad Knees Through the Ages

The average American today is twice as likely to be diagnosed with knee osteoarthritis as in the years before World War II, Harvard scientists say. And the reasons are less clear than you might think.

Based on a study of more than 2,000 skeletons from cadaveric and archaeological collections across the United States, a Harvard report is the first to definitively show that knee osteoarthritis prevalence has dramatically increased in recent decades.

Osteoporosis Care for RA Patients Found Suboptimal, Declining

Fewer than half of rheumatoid arthritis (RA) patients at a risk of fracture sufficient to warrant guideline-recommended osteoporosis treatment received appropriate care, according to a large study of U.S. osteoarthritis (OA) and RA patients.

How Much Testing is Enough?

I saw a patient this past week with new onset polyarthralgia, which led me to ponder how my fellow rheumatologists would utilize laboratory testing in such a patient.

No Evidence to Support Use of Gabapentinoids in Low Back Pain

Management of chronic low back pain (CLBP) is often complex, requiring multiple modalities and meds to control pain. An analysis of studies shows that Gabapentinoids, including pregabalin and gabapentin, have little to no benefits but significant risk of adverse effects.  (Citation source https://buff.ly/2warMSU)

Marijuana Has Little Effect on Most Types of Pain

Cannabis has become a regulated product, and many states have made it available with the intent of treating a variety of medical disorders, including chronic pain. A metanalysis published in Annals of Internal Medicine has shown that while cannabis may help neuropathic pain, it is not proven to benefit other types of chronic pain.

Duration of Azathioprine Maintenance in AAV Does Not Alter Relapse Rates

A European multicentre study examined whether the duration of azathioprine (AZA) maintenance therapy in ANCA-associated vasculitis patients would influence the relapse rate during long-term follow-up.

Psoriatic Arthritis Patients with Comorbidities have Worse Disease and Poor Responses

A population-based cohort study shows that comorbidities in psoriatic arthritis patients (PsA) were associated with higher disease activity, shorter persistence and reduced clinical response to TNF inhibitors (TNFi). 

Uveitis Events Reduced with Select TNF Inhibitors

Uveitis may occur in up to 40% of spondyloarthritis patients. Metanalyses have shown that treatment with tumour necrosis factor-α inhibitor may reduce the rates of anterior uveitis. A multicenter study from Sweden and Norway has confirmed that amongst TNFi, adalimumab and infliximab offer better protection against AU than etanercept.

Kids with Crohn's have Profound MSK Deficits - but No Increase in Fractures

Crohn’s disease (CD), a chronic inflammatory condition of the gastrointestinal tract, is also known for its propensity to affect the musculoskeletal system. Extraintestinal complications of CD include inflammatory polyarthritis, loss of muscle mass, growth retardation and vertebral compression fractures. Some of these are direct results of inflammation or indirect effects of malnutrition.

The RheumNow Week in Review – 11 August 2017

The RheumNow Week in Review caps the week's news every Friday. Dr Jack Cush reviews the news, journal reports and important events from the past week in rheumatology.  This week's news highlights include new data on the incidence of arthritis, lag times in patient referral, criteria for referral and why/how weather change affects arthritis pain.